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PubMed This is a summary of 46 peer-reviewed journal articles Updated
Neurology

Multiple System Atrophy, Parkinsonian Type (MSA-P): A Comprehensive Patient Guide

At a Glance

Multiple System Atrophy, parkinsonian type (MSA-P) is a rare, progressive neurodegenerative disorder that affects both body movement and automatic functions like blood pressure. It is distinct from Parkinson's disease and requires a coordinated, multidisciplinary care team to manage.

Welcome to the resource guide for Multiple System Atrophy, parkinsonian type (MSA-P). Receiving a diagnosis of a rare, progressive neurodegenerative disorder is overwhelming [1]. This guide is designed to empower you and your caregivers with evidence-based information to help you understand your diagnosis, manage your symptoms, and advocate for the best possible care [2].

MSA-P is a complex condition that requires a team-based approach [3]. Because the condition affects both movement and the body’s automatic systems, managing it requires careful balancing of treatments [4]. We have broken down the information into manageable sections so you can find exactly what you need, whether you are trying to understand your initial diagnosis, make sense of an MRI report, or learn how to manage daily blood pressure swings.

Please explore the following sections at your own pace:

01

Finding Your Footing: An Introduction to MSA-P

Learn about Multiple System Atrophy-Parkinsonian type (MSA-P). Understand how it differs from Parkinson's, key symptoms, treatments, and what to expect next.

02

Recognizing the Signs: Motor and Autonomic Symptoms of MSA-P

Learn the symptoms of Multiple System Atrophy-Parkinsonian type (MSA-P). Understand early warning signs, red flags, and how it differs from Parkinson's.

03

The Biology of MSA-P: Why It Differs from Parkinson's

Learn the biological differences between Multiple System Atrophy-Parkinsonian type (MSA-P) and Parkinson's, including how alpha-synuclein affects brain cells.

04

The Diagnostic Toolkit: Criteria, Imaging, and Tests for MSA-P

Learn how Multiple System Atrophy-Parkinsonian type (MSA-P) is diagnosed. Understand 2022 MDS criteria, MRI markers like putaminal atrophy, and autonomic tests.

05

Taking Control: Managing the Symptoms of MSA-P

Learn how to manage Multiple System Atrophy-Parkinsonian type (MSA-P) symptoms. Discover treatments for nOH, stridor, urinary retention, and swallowing issues.

06

Building Your Care Team and Planning for the Future

Learn how to build a multidisciplinary care team for Multiple System Atrophy - Parkinsonian type (MSA-P). Find the right specialists and plan for the future.

Remember, you are the most important member of your care team. Use this information to ask informed questions and ensure your symptoms are being addressed comprehensively.

Common questions in this guide

What is Multiple System Atrophy, parkinsonian type (MSA-P)?
Multiple System Atrophy, parkinsonian type (MSA-P) is a rare, progressive neurodegenerative disorder. It is characterized by its impact on both voluntary movement and the body's automatic systems, such as blood pressure regulation.
How is MSA-P different from Parkinson's disease?
While MSA-P shares some motor symptoms with Parkinson's, it is an atypical parkinsonian disorder that also heavily affects autonomic functions. It progresses differently and requires a unique, carefully balanced treatment approach.
What specialists should be on my MSA-P care team?
Because MSA-P affects multiple systems, you will need a multidisciplinary care team. This typically includes a neurologist alongside physical, occupational, and speech therapists who have experience treating atypical parkinsonian disorders.
Why do I experience blood pressure swings with MSA-P?
Blood pressure fluctuations are a common autonomic symptom of MSA-P. Managing them requires careful balancing of treatments, monitoring your symptoms daily, and keeping open communication with your care team between appointments.
What are the most important first steps after an MSA-P diagnosis?
Early on, focus on defining your quality of life goals and designating a primary healthcare proxy to help make decisions. It is also important to assemble a care team experienced with complex, multi-system disorders to address symptoms as they arise.

Questions to Ask Your Doctor

Curated prompts to bring to your next appointment.

  1. 1.How familiar is your practice with coordinating care for the complex, multi-system needs of an MSA-P patient?
  2. 2.Can you provide referrals to physical, occupational, and speech therapists who specifically have experience with atypical parkinsonian disorders?
  3. 3.What is the most effective way to communicate with you and the care team between scheduled appointments if new symptoms arise?

Questions For You

Tap a prompt to share your answer — we'll use it plus this page's context to start a tailored conversation.

References

References (4)
  1. 1

    A historical review of multiple system atrophy with a critical appraisal of cellular and animal models.

    Marmion DJ, Peelaerts W, Kordower JH

    Journal of neural transmission (Vienna, Austria : 1996) 2021; (128(10)):1507-1527 doi:10.1007/s00702-021-02419-8.

    PMID: 34613484
  2. 2

    A strategic approach of the management of sleep-disordered breathing in multiple system atrophy.

    Laga A, Bauters F, Hertegonne K, et al.

    Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine 2025; (21(4)):703-711 doi:10.5664/jcsm.11472.

    PMID: 39539061
  3. 3

    Therapeutic Management of the Overlapping Syndromes of Atypical Parkinsonism.

    Giagkou N, Stamelou M

    CNS drugs 2018; (32(9)):827-837 doi:10.1007/s40263-018-0551-3.

    PMID: 30051337
  4. 4

    Management Strategies for Comorbid Supine Hypertension in Patients with Neurogenic Orthostatic Hypotension.

    Isaacson SH, Dashtipour K, Mehdirad AA, Peltier AC

    Current neurology and neuroscience reports 2021; (21(4)):18 doi:10.1007/s11910-021-01104-3.

    PMID: 33687577

This guide provides educational information about Multiple System Atrophy, parkinsonian type (MSA-P) for patients and caregivers. It is not a substitute for professional medical advice, diagnosis, or treatment from your neurologist or care team.

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